Evaluating healthcare workers' hand hygiene performance using first-person view video observation in a standardized patient-care scenario

Background: Monitoring healthcare workers' (HCWs) hand hygiene (HH) performance is recommended for improving compliance. Observer biases challenge data validity, thus supplemental approaches such as video observation are needed to complement monitoring. Methods: We investigate first-person view (FPV) video observation during simulated standardized patient care handling a catheter in a study with 71 HCWs. HH performance was evaluated for (1) all HH opportunities and (2) a subset of opportunities required in an ideal work sequence, hereafter core opportunities. HCWs' acceptance of FPV video observation and usability judgments were assessed. Results: Compliance level for core HH opportunities (M=43.5%) was significantly higher than compliance considering all opportunities (M=30.4%, t(70)=8.493, P<.001). Reducing HH opportunities to core opportunities would significantly increase compliance levels from the observed average of 30.4% to 44.9% (t(70)=12.822, P<.001). Overall, both usability ratings and acceptance of the body camera were promising. Discussion: FPV video observation in simulated standardized patient care provides new instruments to evaluate HH performance beyond mere compliance rates. Our results emphasize the role of optimizing workflow in order to improve HCW's HH compliance. Conclusions: FPV video observation in a standardized patient care simulation is feasible and offers information for HH interventions that target actual deficiencies. (C) 2019 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.